Late effects after breast cancer among low income women in the Southern United States.


Purpose: To describe complaints of physical and functional late effects after breast cancer treatment among low-income breast cancer survivors (BCS). Methods & Data: We interviewed 522 BCS for inclusion in the Southern Community Cancer Survivorship Study. This study focuses on BC-specific physical & functional recovery & comorbidity. We used multivariate regression analyses to assess how these outcomes vary by socio-demographic & treatment factors. Results: Half the BCS were African American (AA) & half white; 58% of AAs vs. 36% of whites reported annual incomes < $20,000. Low income BCS were more likely to report mastectomy (odds ratio=1.7, 95%CI 1.2-2.4) & less likely to report chemotherapy (OR=0.9, 95%CI 0.6-1.2) or radiation (OR=0.6, 95%CI 0.4-0.8). The majority (86%) had physical and functional complaints related to BC treatment, with little difference by race, but consistently higher among those with low income. Low-income subjects more often reported barriers to receiving physical therapy. Hypertension & diabetes were more common among AA, but 10 of the 12 co-morbid conditions were reported significantly more often among those with low income. The most significant predictors of complaints were low income, younger age & lack of private health insurance. Numbers of comorbidities, therapies, and barriers to PT also were significant predictors of complaints. Significance. Our study suggests disparities in physical & functional levels among BCS are associated with low income rather than race or education. Challenges remain to eliminate late effects of BC treatment. We continue to examine the effects of lymphedema and shoulder range of motion.